1. Field of the Invention
This invention relates to facilitating the transfer of the exit site of a catheter from the mouth to the nose. Devices that typically require this assistance include nasobiliary stents and endoscopically placed drainage and feeding devices. A device of the present invention could be useful in other procedures as well, such as, for example, the stabilization of nasally placed devices by a maneuver known as "bridling."
2. Description of the Prior Art
It is sometimes desirable to place a catheter into the biliary system, pancreas, or upper gastrointestinal tract through the mouth. After the catheter has been endoscopically implanted, the proximal end of the catheter is stationed out of the mouth of the patient. It is preferable, however, to transfer the exit site of the catheter to the nose, which is much more convenient and comfortable for the patient and reduces the risk that the catheter will be damaged by mastication. The transfer procedure is typically accomplished with the use of a well-lubricated nasopharyngeal tube which is advanced through the nostril and down the pharynx. The endoscopist then grasps the tip of the nasopharyngeal tube in the posterior oropharynx region with his or her index finger (or sometimes with forceps) and pulls it out through the mouth. The tip of the catheter is then threaded through a hole at or near the oral end of the nasopharyngeal tube and advanced until it exits through the nasal end of the tube. The nasopharyngeal tube is then slowly pulled out through the nostril, bringing the catheter along with it.
Problems are encountered in this procedure, however, in the process of locating, grasping, and pulling the nasopharyngeal tube out through the mouth once it has been advanced into the posterior oropharynx region. This is at least partly because the nasopharyngeal tube can sometimes be difficult to locate and grasp, particularly if the physician or assistant performing the maneuver has shorter fingers or the patient has an unusually small mouth. On occasion, the grasping digit has been bitten by the patient while trying to locate and pull the nasopharyngeal tube out through the mouth. The alternative of using a grasping instrument such as forceps, on the other hand, means that the posterior oropharynx region must be probed blindly to locate and securely grasp the nasopharyngeal tube for extraction. Without the benefit of a visual or tactile aid, a fair amount of time and effort is often required before the nasopharyngeal tube can be successfully extracted from the patient with forceps. And, as with the experience of having a hand reach into the back of your mouth, this blind probing with a foreign instrument into a sensitive region of the body can be uncomfortable and unpleasant for the patient and can result in trauma to the pharyngeal tissues. Both patient and physician would benefit from an improved way of accomplishing the transfer of a catheter from the mouth to the nose. Such an improved procedure would enable the physician to easily locate and extract the nasopharyngeal transfer device, and would do so in a way that would alleviate the unpleasantness and risks of the experience to the patient.